Reconfirmation of ECG-assisted catheter tip placement

ABSTRACT

A catheter includes a proximal portion designed for residing externally of a patient vasculature and a distal portion having a distal tip designed for placement in a desired position within the patient vasculature. A storage component is embedded in a portion of the catheter, the storage component including a radio-frequency identification (RFID) chip. The RFID chip includes non-volatile memory that is programmable by a RFID encoder. The storage component includes data related to the placement of the distal tip of the catheter in the desired position within the patient vasculature.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a division of U.S. patent application Ser. No.13/213,622, filed Aug. 19, 2011, which claims the benefit of U.S.Provisional Application No. 61/375,442, filed Aug. 20, 2010, titled“System for Reconfirmation of ECG-Assisted Catheter Tip Placement,” eachof which is incorporated herein by reference in its entirety.

BRIEF SUMMARY

Briefly summarized, embodiments of the present invention are directed toreconfirmation of a position of a catheter or other indwelling devicethat has been placed with the assistance of ECG signals of the patient.The system and methods described herein enable a clinician to confirmwhether the distal tip of the indwelling catheter remains positioned inthe same location as when the catheter was initially placed. Should thetip be found to have migrated to another position, steps can be taken toreturn it to its proper position.

In one embodiment a method for reconfirming a position of an indwellingmedical device within a body of a patient comprises first placing themedical device within the body of the patient using ECG signals of thepatient. A first ECG signal profile relating to an initial position ofthe indwelling medical device after initial placement of the medicaldevice is complete is stored. A second ECG signal profile relating to aposition of the indwelling medical device at a time subsequent toinitial placement of the medical device is then acquired. The first ECGsignal profile is compared with the second ECG signal profile todetermine whether displacement of the indwelling medical device hasoccurred after initial placement of the medical device. If displacementhas occurred, the clinician can take the necessary steps to repositionthe catheter as needed.

These and other features of embodiments of the present invention willbecome more fully apparent from the following description and appendedclaims, or may be learned by the practice of embodiments of theinvention as set forth hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

A more particular description of the present disclosure will be renderedby reference to specific embodiments thereof that are illustrated in theappended drawings. It is appreciated that these drawings depict onlytypical embodiments of the invention and are therefore not to beconsidered limiting of its scope. Example embodiments of the inventionwill be described and explained with additional specificity and detailthrough the use of the accompanying drawings in which:

FIG. 1 is a block diagram depicting various elements of a system forintravascular placement of a catheter, according to one exampleembodiment of the present invention;

FIG. 2 is a simplified view of a patient and a catheter being insertedtherein with assistance of the system of FIG. 1;

FIG. 3 is a partial cutaway view of a conductive pathway configurationwithin the catheter of FIG. 2 in accordance with one embodiment;

FIG. 4 is a perspective view of a card reader/encoder system for use inaccordance with one embodiment;

FIG. 5 is a top view of a catheter bifurcation including an RFID chip inaccordance with one embodiment;

FIG. 6 is a simplified top view of an RFID reader/encoder; and

FIG. 7 is a screenshot of the display of the system of FIG. 2 showing aplurality of ECG waveforms during use of the system in confirming aposition of a catheter, in accordance with one embodiment.

DETAILED DESCRIPTION OF SELECTED EMBODIMENTS

Reference will now be made to figures wherein like structures will beprovided with like reference designations. It is understood that thedrawings are diagrammatic and schematic representations of exemplaryembodiments of the present invention, and are neither limiting nornecessarily drawn to scale.

For clarity it is to be understood that the word “proximal” refers to adirection relatively closer to a clinician using the device to bedescribed herein, while the word “distal” refers to a directionrelatively further from the clinician. For example, the end of acatheter placed within the body of a patient is considered a distal endof the catheter, while the catheter end remaining outside the body is aproximal end of the catheter. Also, the words “including,” “has,” and“having,” as used herein, including the claims, shall have the samemeaning as the word “comprising.”

Embodiments of the present invention are generally directed toreconfirmation of a position of a catheter or other indwelling devicethat has been placed with the assistance of ECG signals of the patient.As is explained herein, the system and methods described hereinparticularly enable a clinician to confirm whether the distal tip of theindwelling catheter remains positioned in the same location as when thecatheter was initially placed. Should the tip be found to have migratedto another position, steps can be taken to return it to its properposition.

Reference is first made to FIGS. 1 and 2, where one example of acatheter placement and monitoring system, generally designated at 10, isshown. The system 10 enables visualization of a subcutaneous vessel of apatient 70 via ultrasound imaging, followed by insertion, advancement,and final placement of a catheter 72 within the patient's vasculaturevia monitoring of ECG signals emitted by the SA node of the patient'sheart. A simplified block diagram of hardware and other components ofthe system 10 is shown in FIG. 1, while FIG. 2 depicts the system andcatheter 72 in relation to the patient 70. As shown, the system 10 inone embodiment generally includes a console 20 housing a display 30, anultrasound probe 40, and a sensor unit 50 for placement on the chest ofthe patient 70.

In greater detail and as mentioned above, FIG. 2 shows the generalrelation of the components of the system 10 to a patient 70 during aprocedure to place the catheter 72 into the patient vasculature througha skin insertion site 73. FIG. 2 shows that the catheter 72 generallyincludes a proximal portion 74 that remains exterior to the patient anda distal portion 76 that resides within the patient vasculature afterplacement is complete. The system 10 is employed to ultimately positiona distal tip 76A of the catheter 72 in a desired position within thepatient vasculature. In one embodiment, the desired position for thecatheter distal tip 76A is proximate the patient's heart, such as in thelower one-third (⅓^(rd)) portion of the Superior Vena Cava (“SVC”). Ofcourse, the system 10 can be employed to place the catheter distal tipin other locations. The catheter proximal portion 74 further includes abifurcation 74A that provides fluid communication between the one ormore lumens of the catheter 72 and one or more extension legs 74Bextending proximally from the hub. Each extension leg 74B includes aluer connector 74C for attachment to suitable medical devices.

The console 20 houses various components necessary for operation of thesystem 10. A processor 22, including non-volatile memory such as EEPROMfor instance, is included in the console 20 for controlling systemfunction during operation of the system 10, thus acting as a controlprocessor. A digital controller/analog interface 24 is also includedwith the console 20 and is in communication with both the processor 22and other system components to govern interfacing between the ultrasoundprobe 40, sensor 50, and other system components.

The console 20 further includes ports 52 for connection with the sensor50 and optional components 54 including a printer, storage media,keyboard, etc. The ports 52 in one embodiment are USB ports, thoughother port types or a combination of port types can be used for this andthe other interfaces connections described herein. A power connection 56is included with the console 20 to enable operable connection to anexternal power supply 58. An internal battery 60 can also be employed,either with or exclusive of an external power supply. Power managementcircuitry 59 is included with the digital controller/analog interface 24of the console to regulate power use and distribution.

The display 30 of the system 10 in the present embodiment is integratedinto the console 20 and is used to display information to the clinicianduring the catheter placement procedure, and as will be seen, duringreconfirmation of catheter distal tip position in accordance withembodiments to be described below. Optionally, the display may beseparate from the console. In one embodiment, a console button interface32 and buttons included on the probe 40 can be used to controlfunctionality of the system 10 during the catheter placement procedure.Thus, the single display 30 of the system console 20 can be employed forultrasound guidance in accessing a patient's vasculature, ECG-basedconfirmation of catheter distal tip placement with respect to a node ofthe patient's heart, as well as subsequent confirmation of catheterdistal tip position, as will be seen below. In one embodiment, thedisplay 30 is an LCD device.

As mentioned above, the ultrasound probe 40 is employed in connectionwith ultrasound (“US”)-based visualization of a subcutaneous vessel,such as a vein, in preparation for insertion of the catheter 72 into thevasculature. Such visualization gives real time ultrasound guidance forintroducing the catheter into the vasculature of the patient (via theinsertion site 73) and assists in reducing complications typicallyassociated with such introduction, including inadvertent arterialpuncture, hematoma, pneumothorax, etc.

The handheld probe 40 includes a head housing a piezoelectric array forproducing ultrasonic pulses and for receiving echoes thereof afterreflection by the patient's body when the head is placed against thepatient's skin proximate the prospective insertion site 73. The probe 40can further include a plurality of control buttons for controlling thesystem 10, thus eliminating the need for the clinician to reach out ofthe sterile field, which is established about the patient insertion siteprior to catheter placement, to control system functionality.

As such, in one embodiment a clinician employs the ultrasound modalityof the system 10 to determine a suitable insertion site and establishvascular access, such as with a needle or introducer, then with thecatheter. The clinician can then seamlessly switch, via button pushes onthe buttons included on the probe 40, to an ECG-based catheter tipguidance modality (described below), without having to reach out of thesterile field. In this way, the system 10 assists the clinician inguiding the distal tip of the catheter 72 through the vasculature towardan intended destination.

FIG. 1 shows that the probe 40 further includes a button and memorycontroller 42 for governing button and probe operation. The button andmemory controller 42 can include non-volatile memory, such as EEPROM, inone embodiment. The button and memory controller 42 is in operablecommunication with a probe interface 44 of the console 20, whichincludes a piezo input/output component 44A for interfacing with theprobe piezoelectric array and a button and memory input/output component44B for interfacing with the button and memory controller 42.

As mentioned, the system 10 includes functionality wherein determinationof the proximity of the catheter distal tip 76A relative to asino-atrial (“SA”) or other electrical impulse-emitting node of theheart of the patient 70 can be determined, thus providing enhancedability to accurately place the catheter distal tip in a desiredlocation proximate the node. Also referred to herein as “ECG” or“ECG-based tip confirmation,” this modality of the system 10 enablesdetection of ECG signals from the SA node in order to place the catheterdistal tip in a desired location within the patient vasculature. Notethat the US and ECG modalities are seamlessly combined in the presentsystem 10, and can be employed in concert or individually to assist incatheter placement. In addition, other modalities, such as magneticelement-based catheter tip location, can also be included in the system10. In one embodiment, it is understood that the ECG modality asdescribed herein can be included in a stand-alone system without theinclusion of the US or other modalities. Thus, the environments in whichthe embodiments herein are described are understood as merely exampleenvironments and are not considered limiting of the present disclosure.Note also that other ECG-based guidance/monitoring systems can beemployed in connection with the distal tip reconfirmation embodimentsdescribed further below.

FIGS. 1 and 2 show a stylet 130 removably predisposed within the lumenof the catheter 72 being inserted into the patient 70 via the insertionsite 73. The stylet 130 includes a sensing component, i.e., an electrodeproximate its distal end for sensing ECG signals produced by the SAnode. The stylet 130 includes a tether 134 extending from its proximalend that operably connects to the sensor 50. In brief, the stylet tether134 provides a conductive path that permits ECG signals detected by theECG electrode included on a distal portion of the stylet 130 to beconveyed to the sensor 50 during catheter advancement.

Reference and ground ECG skin electrodes 138 attach to the skin surfaceof the patient 70 and are operably attached to the sensor 50 to enablethe system to filter out high level electrical activity unrelated to theelectrical activity of the SA node of the heart, thus enabling theECG-based tip confirmation functionality. Together with the referenceand ground signals received from the ECG skin electrodes 138 placed onthe patient's skin, the ECG signals sensed by the stylet electrode arereceived by the sensor 50 positioned on the patient's chest or otherdesignated component of the system 10. The sensor 50 and/or consoleprocessor 22 can process the ECG signal data to produce anelectrocardiogram waveform on the display 30. In the case where thesensor 50 processes the ECG signal data, a processor is included thereinto perform the intended functionality. If the console 20 processes theECG signal data, the processor 22, controller 24, or other processor canbe utilized in the console to process the data.

Thus, as the catheter 72 is advanced through the patient vasculature,the display 30 depicts an ECG electrocardiogram waveform produced as aresult of patient heart's electrical activity as detected by theelectrode of the stylet 130. In greater detail, the ECG electricalactivity of the SA node, including a P-wave portion of the waveform, isdetected by the electrode of the stylet 130 and forwarded to the sensor50 and console 20. The ECG electrical activity is then processed fordepiction on the display 30. A clinician placing the catheter can thenobserve the ECG data, including depiction of the P-wave, to determineoptimum placement of the distal tip 76A of the catheter 72, such asproximate the SA node in one embodiment.

Note that the ECG waveform and its P-wave change as the electrode of thestylet 130 is moved relative to the SA node of the patient's heart Forinstance, the P-wave of the ECG waveform will generally increase inamplitude as the electrode approaches the SA node and will generallydecrease as the electrode recedes from the SA node. As mentioned, in oneembodiment the console 20 includes the electronic components, such asthe processor 22, necessary to receive and process the ECG signalsdetected by the stylet electrode. In another embodiment, the sensor 50can include the necessary electronic components to process the ECGsignals. Further details regarding the catheter placement systemdescribed herein and its use can be found in U.S. Patent ApplicationPublication No. 2010/0036227, filed Sep. 10, 2009, and entitled“Apparatus and Display Methods Relating to Intravascular Placement of aCatheter,” which is incorporated herein by reference in its entirety. Ofcourse, it is appreciated that the ECG-based catheter placement systemdescribed above is but one example of an ECG monitor that can be used topractice the embodiments disclosed herein; indeed, other ECG-basedmonitoring and placement systems can also be employed.

Note that the electrode of the stylet 130 in the present embodimentincludes a distal portion of the conductive stylet wire such that ECGsignals are detected and transmitted via the stylet wire to the tether134 and the sensor 50. It is noted, however, that an electrode used todetect intravascular ECG signals can be configured in many differentways. As such, “electrode” as used herein can generally refer to anystructure that can be used to detect ECG signals from the heart of thepatient. As will be seen, an electrode in other embodiments can includea portion of a column of conductive solution disposed in a lumen of thecatheter, among other possible electrode configurations.

As described further above, monitoring of changes in the detected ECGsignal emitted by the SA node as the stylet electrode(s) is advancedwithin the vasculature enables the clinician placing the catheter todetermine when the distal tip of the catheter 72 is positioned asdesired within the vasculature. Again, one example of a desirablecatheter distal tip position includes placement thereof in the lower⅓^(rd) of the Superior Vena Cava (“SVC”). After placement of thecatheter 72 is complete, the stylet 130 is removed from the lumen of thecatheter 72 and the catheter is prepped for initial use. The ECGwaveform detected when the distal tip 76A of the catheter 72 isinitially placed in its desired position within the patient vasculatureis also referred to herein as the first ECG signal profile.

It is often desirable to re-confirm the position of the catheter distaltip 76A at a later time after initial placement of the catheter so as toensure that no malposition or displacement of the distal tip hasinadvertently occurred. In turn, this ensures that medicaments or othersolutions delivered to the patient via the catheter are delivered to thedesired region of the vasculature. The system 10 or other suitable ECGmonitoring system can be employed in reconfirming proper catheter distaltip position post-placement.

In one embodiment, such reconfirmation of catheter distal tip placementcan be achieved by measuring the ECG waveform—also referred to herein asa second ECG signal profile—detected at or near the distal tip of thein-place catheter via a suitably placed electrode, then comparing thesecond ECG profile with the first ECG profile taken when the catheter 72was initially placed using the system 10.

In order to measure ECG signals at the indwelling catheter distal tipand thus acquire the second ECG profile, a suitable conductive path mustbe present in the catheter 72 to enable ECG signals with respect to thecatheter distal tip to be detected and transmitted to the system 10 orother suitable ECG monitor. In one embodiment, a conductive wiretemporarily disposed in the catheter is used as the conductive medium,with its distal end serving as an electrode for detection of ECGsignals. The conductive wire can be inserted through one of the luerconnectors 74C and its respective extension leg 74B, then distallythrough a lumen of the catheter 72. Knowing the length of the in-placecatheter 72, the wire is advanced until its distal end is proximate toor co-terminal with the distal tip 76A of the catheter.

A proximal end of the conductive wire extending beyond the proximal endof the catheter 72 and out the extension leg 74B through which the wireextends is operably connected to the system 10 in a manner similar tothat of the stylet 130 and tether 134 of FIG. 2. This configurationenables ECG signals emitted by the SA node, i.e., the second ECGprofile, to be detected at or near the distal end of the conductive wireand transmitted via the conductive wire to the system 10, thus informingthe clinician as to ECG profile of the distal tip 76A of the catheter 72in its current position.

As mentioned, the conductive wire configured as discussed immediatelyabove is similar to the stylet 130 shown in FIG. 2. Indeed, in oneembodiment the stylet 130 used for the initial catheter placement can beused again subsequent to the initial placement to reconfirm catheterdistal tip location by inserting it into the lumen of the catheter 72and operably connecting it to the system 10 via the tether 134 as shownin FIG. 2 so as to enable the second ECG profile of the catheter distaltip in its current location to be acquired. In addition, anothersuitable stylet or guidewire can be employed to provide theabove-described conductive path from the catheter distal tip to thesystem.

FIG. 3 shows details of another configuration for providing a conductivepath between an electrode at or near the indwelling catheter distal end76A and the system 10 for tip position reconfirmation. In particular,the conductive path includes a conductive solution 200 disposed in therespective extension leg 74B and lumen of the catheter 72 so as toextend to the distal tip 76A thereof. The conductive solution 200includes saline, or other biocompatible and electrically conductivesolution. So configured, the conductive solution 200 serves as anelectrode and a portion of a conductive path for detecting ECG signalsat the distal tip 76A of the catheter 72. A cap 202 is connected to theluer connector 74C of the respective fluid-filled extension leg 74B.

In addition to the conductive solution 200, the conductive path of theembodiment of FIG. 3 further includes a conductive wire 208 that passesthrough the cap 202 and extends distally through the respectiveextension leg 74B such that a distal end 208B thereof is immersed in theconductive solution. A proximal portion of the conductive wire 208terminating in a proximal end 208A extends from the cap 202. Analligator clip 210 or other suitable electrical connector is attached tothe proximal portion of the conductive wire 208. The clip 210 isoperably connected to a tether 234, which connects to the sensor 50 ofthe system 10, similar to the manner of connection of the tether 134 inFIG. 2, thus operably connecting the column of the conductive solution200 disposed in the catheter 72 to the system and enabling ECG signalsdetected by the conductive solution to be transmitted to the system. Inthis way, the second ECG signal profile representing the position of thedistal tip 76A of the catheter 72 within the vasculature can beacquired. In addition to those described in connection with FIGS. 2 and3, note that other conductive path configurations can be employed inother embodiments. Thus, these conductive path solutions should beconsidered as non-limiting.

In order to compare the first ECG signal profile acquired at the time ofinitial catheter distal tip placement with a subsequent second ECGprofile measured at the time of distal tip position reconfirmation, astorage component for storage of the first ECG signal profile at thetime of initial placement is necessary. In one embodiment, this isaccomplished by fitting the system 10 or other suitable ECG monitorsystem with a card reader/encoder 250, an example of which is shown inFIG. 4 as attached to the console 20. Thus, when the catheter 72 isinitially placed using the system 10, a patient data card 254 can beencoded by the system 10 by swiping the card through the reader/encoder250, which encodes and stores on a magnetic stripe 256 of the data cardvarious data regarding the initial catheter placement, including thefirst ECG signal profile at time of initial placement. The card 254 isthen given to the patient or otherwise safeguarded.

Later, when reconfirmation of the position of the distal tip 76A of thepreviously placed catheter 72 (FIG. 1) is desired, the catheter isoperably connected to the system 10 in one of the configurationsdescribed above in connection with FIG. 2, 3, or by another suitablemanner so as to provide a conductive path from the distal tip 76A of thecatheter to the system. The card 254, encoded at time of initialcatheter placement is then swiped through the reader/encoder 250 of thesystem 10 so as to be read thereby. This provides to the system 10 thefirst ECG signal profile of the catheter distal tip position at time ofinitial placement. The first ECG signal profile, including for instancean ECG waveform as detected by an electrode at or near the distal end76A of the catheter 72 at time of initial placement, can be depicted onthe display 30 of the system console 20 (FIG. 1), or otherwise conveyedto the clinician.

A new ECG signal measurement, using an electrode disposed at or near thedistal tip 76A of the catheter 72 and the suitable conductive pathinterconnecting the electrode with the system 10, is then taken toproduce a second ECG signal profile relating to the current catheterdistal tip position within the vasculature. The second ECVG signalprofile can, like the first ECG signal profile, also be depicted on thedisplay 30 of the system console 20. The two ECG signal profiles can besuperimposed as ECG waveforms atop one another and compared in somesuitable manner (e.g., measurement of P-wave absolute voltage values) soas determine whether the distal tip 76A of the catheter 72 has beenundesirably displaced. If so, proper procedures can be undertaken by theclinician to suitably re-position the catheter distal tip 76A. If it hasnot been displaced, the catheter 72 can be used as intended. Note thatthe specific order of the process described above can vary in otherembodiments. For instance, acquisition of the second ECG signal profilecan take place before inputting the first ECG signal profile into thesystem, in one embodiment.

FIG. 5 shows another possible storage component for enabling storage andaccess to initial placement first ECG signal profile and other data,wherein an RFID chip 270 is embedded in a portion of the catheter 72itself, such as the bifurcation 74A (see also FIG. 2). An RFIDencoder/reader 274 including an antenna 280 and associated circuitry282, as shown in FIG. 6, can be included with the system 10 or othersuitable ECG monitor to enable the first ECG signal profile relating tothe position of the catheter distal tip 76A at time of initial placementto be encoded and stored on the catheter RFID chip 270. In oneembodiment, the RFID chip 270 is a field-programmable chip, includingboth read-only memory for unique identification of the chip itself, aswell as non-volatile memory that is programmable by the RFIDencoder/reader 274 to store the first ECG signal profile at time ofinitial placement.

In addition to the first ECG signal profile, other data can be stored onthe RFID chip 270 (or the card 254 of FIG. 4 or other suitable storagecomponent), including patient name, date and location of initialplacement, final length of catheter after trimming, record of previouspower injections, creatinine or other blood counts, etc. In oneembodiment, the length of the portion of the PICC that remains externalto the insertion site after placement is complete is stored. In anotherembodiment, web portal information can be stored to direct a user to awebsite where useful information or other assistance is provided. Notethat the RFID chip 270 can be either active or passive. Note furtherthat other storage components are possible for storing the first and/orsecond ECG signal profiles, including a memory location within thesystem 10 itself and remote offsite storage wherein the ECG signalmonitor can access the profiles wirelessly, such as via WiFi or othersuitable wireless protocol.

FIG. 7 shows one possible example of a screenshot 300 for depiction onthe display 30 of the system 10 during reconfirmation of the catheterdistal tip position, according to one embodiment. As shown, thescreenshot 300 shows ECG waveforms 310, including a waveform 310Acorresponding to the first ECG signal profile at time of initialcatheter placement and a waveform 310B corresponding to the second ECGsignal profile at time of reconfirmation of the distal tip placement,described above. The two waveforms 310A and 310B can be calibrated bythe system 10 and superimposed atop one another in one embodiment so asto enable a comparison therebetween to be made. In one embodiment, forinstance, a P-wave 312A of the initial waveform 310A can be comparedwith a P-wave 312B of the current waveform 310B so as to determinewhether displacement of the catheter distal tip 76A with respect to theSA node has occurred.

The right side of the screenshot 300 also shows additional data 314regarding the patient, catheter type, catheter length, etc. Of course,the ECG signal and other data depicted here can take one or more of manyforms and formats. Indeed, the data content can vary according to desireor need, as appreciated by one skilled in the art. In one embodiment forinstance, both the peak P-wave magnitude during initial catheterplacement, as well as the P-wave magnitude after catheter pull-back forfinal distal tip positioning during initial placement, are stored forlater comparison with similar magnitudes taken at time of tipreconfirmation.

Thus, according to one embodiment a method is disclosed for reconfirminga position of a catheter or other indwelling medical device within abody of a patient. The method includes placing the medical device withinthe body of the patient using ECG signals of the patient, then storing afirst ECG signal profile that relates to an initial position of theindwelling medical device after initial placement of the medical deviceis complete. As mentioned, the first ECG signal profile can be stored ona patient card, an RFID chip, in system memory, writing down or printingthe ECG signal data, or on another suitable storage component. Themethod further includes acquiring a second ECG signal profile relatingto a position of the indwelling medical device at a time after initialplacement of the medical device, and comparing the first ECG signalprofile with the second ECG signal profile to determine whetherdisplacement of the indwelling medical device has occurred after initialplacement of the medical device. Note that comparing the profiles can beperformed directly by a clinician observing the waveforms depicted onthe console display 30, or automatically by suitable algorithmsexecutable by the processor 22 of the console 20.

Embodiments of the invention may be embodied in other specific formswithout departing from the spirit of the present disclosure. Thedescribed embodiments are to be considered in all respects only asillustrative, not restrictive. The scope of the embodiments is,therefore, indicated by the appended claims rather than by the foregoingdescription. All changes that come within the meaning and range ofequivalency of the claims are to be embraced within their scope.

What is claimed is:
 1. A catheter, comprising: a proximal portiondesigned for residing externally of a patient vasculature; a distalportion having a distal tip designed for placement in a desired positionwithin the patient vasculature; a storage component embedded in aportion of the catheter, comprising a radio-frequency identification(RFID) chip, the RFID chip including non-volatile memory that isprogrammable by a RFID encoder, the storage component including dataindicating location of a final placement of the distal tip in thedesired position within the patient vasculature.
 2. The catheteraccording to claim 1, wherein the catheter includes a bifurcationportion, and wherein the storage component is embedded in thebifurcation portion of the catheter.
 3. The catheter according to claim1, further comprising trimming of the catheter, and wherein the dataindicating location of the final placement further includes dataselected from the group consisting of a date of the final placement, afinal length of the catheter after trimming, and patient creatine orother blood counts.
 4. The catheter according to claim 1, wherein thecatheter is a peripherally inserted central catheter (PICC) and the dataindicating location of the final placement further includes a length ofa proximal portion of the PICC after placement is complete.
 5. Thecatheter according to claim 1, wherein the data indicating location ofthe final placement further includes a first ECG signal profile relatingto a position of the distal tip in the desired position at a time ofinitial placement.
 6. The catheter according to claim 1, furthercomprising a power injection procedure, wherein the storage componentfurther includes data comprising a record of power injection proceduresfor the patient.